Drowsy patients

[viprn21, BSN, RN]

Hi all,

Let me start with I work days. I've noticed that a lot of people who work nights at my facility chart the patient as "drowsy" in the middle of the night and give them a GCS of 14 instead of 15. In my mind, I feel like there's a difference between "you woke me up at 3AM to do a neuro check drowsy" and an actual change in mental status.

What say you fellow nurses? If you wake the patient up and they're sleepy, do you chart a lower GCS?

[canoehead, BSN, RN]

Yes, I chart GCS of 14, and "wakes to voice" and consider it a normal finding.

[Duranie]

I see it like you do, viprn... As far as I'm concerned, being drowsy when awakened in the middle of the night is a normal finding, and would represent a patient's baseline.

I wouldn't deduct a point, but would probably put in the notes that the pt. was appropriately arousable, drowsy upon awakening and went back to sleep readily. (assuming that was what I observed.)

It'd be different if the patient was especially difficult to arouse, or was so drowsy that I couldn't say they really even woke up, or if they seemed more confused/disoriented than normal.

[KarenMS]

I think it's appropriate to chart what you see, in this case drowsy, and then trend the findings. The patient is consistently drowsy at 3am? Makes sense, not a worry.